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Beliefs that Condoms Reduce Sexual Pleasure—Gender Differences in Correlates Among Heterosexual HIV-Positive Injection Drug Users (IDUs)

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Abstract

Studies consistently find that negative condom beliefs or attitudes are significantly associated with less condom use in various populations, including HIV-positive injection drug users (IDUs). As part of efforts to reduce sexual risk among HIV-positive IDUs, one of the goals of HIV interventions should be the promotion of positive condom beliefs. In this paper we sought to identify the correlates of negative condom beliefs and examined whether such correlates varied by gender, using a subsample (those with an opposite-sex main partner; n = 348) of baseline data collected as part of a randomized controlled study of HIV-positive IDUs. In multivariate analyses, we found more significant correlates for women than for men. With men, perception that their sex partner is not supportive of condom use (negative partner norm) was the only significant correlate (Beta = −0.30; p < 0.01; R 2 = 0.18). Among women, negative partner norm (Beta = −0.18; p < 0.05); having less knowledge about HIV, STD, and hepatitis (Beta = −0.16; p < 0.05); lower self-efficacy for using a condom (Beta = −0.40; p < 0.01); and more episodes of partner violence (Beta = 0.15; p < 0.05) were significantly associated with negative condom beliefs (R 2 = 0.36). These findings suggest important gender-specific factors to consider in interventions that seek to promote positive condom beliefs among HIV-positive IDUs.

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Acknowledgements

The authors wish to acknowledge the study participants in all four communities who made this research possible and the study staff for their outstanding commitment to the success of this project. The authors also wish to thank the members of the community advisory boards and HIV program review panels at each site for providing constructive feedback on the intervention and trial designs.

The INSPIRE Study Group includes the following people: Carl Latkin, Amy Knowlton, Karin Tobin (Baltimore), Lisa Metsch, Eduardo Valverde, James Wilkinson, Martina DeVarona (Miami), Mary Latka, Dave Vlahov, Phillip Coffin, Marc Gourevitch, Julia Arnsten, Robert Gern (New York), Cynthia Gomez, Kelly Knight, Carol Dawson Rose, Starley Shade, Sonja Mackenzie (San Francisco), David Purcell, Yuko Mizuno, Scott Santibanez, Richard Garfein, Ann O’Leary (CDC), Lois Eldred, and Kathleen Handley (Health Resources and Services Administration).

We would also like to acknowledge the following people for their contributions to this research: Susan Sherman, Roeina Marvin, Joanne Jenkins, Donny Gann, Tonya Johnson (Baltimore), Clyde McCoy, Rob Malow, Wei Zhao, Lauren Gooden, Sam Comerford, Virginia Locascio, Curtis Delford, Laurel Hall, Henry Boza, Cheryl Riles (Miami), George Fesser, Victoria Frye, Carol Gerran, Laxmi Modali, Diane Thornton (New York), Caryn Pelegrino, Barbara Garcia, Jeff Moore, Erin Rowley, Debra Allen, Dinah Iglesia-Usog, Gilda Mendez, Paula Lum, Greg Austin (San Francisco), Craig Borkowf, Ying Chen, Gladys Ibanez, Hae-Young Kim, Toni McWhorter, Jan Moore, Lynn Paxton, John Williamson (CDC), Lee Lam, Jeanne Urban, Stephen Soroka, Zilma Rey, Astrid Ortiz, Sheila Bashirian, Marjorie Hubbard, Karen Tao, Bharat Parekh, and Thomas Spira (CDC Laboratory).

This study was supported by the Centers for Disease Control and Prevention and the Health Resources and Services Administration. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

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Correspondence to Yuko Mizuno PhD.

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Mizuno and Purcell are with the Prevention Research Branch, Division of HIV/AIDS Prevention National Center for HIV/STD/TB Prevention, Centers for Disease Control and Prevention, Altanta, GA, USA; at time of the study, Latka was with the Center for Urban Epidemiologic Studies, New York Academy of Medicine, New York, NY, USA; Metsch is with the University of Miami, Miami FL, USA; at time of the study, Gomez was with the University of California - San Francisco, San Francisco, CA, USA; Latkin is with the Johns Hopkins University, Baltimore, MD, USA.

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Mizuno, Y., Purcell, D.W., Latka, M.H. et al. Beliefs that Condoms Reduce Sexual Pleasure—Gender Differences in Correlates Among Heterosexual HIV-Positive Injection Drug Users (IDUs). J Urban Health 84, 523–536 (2007). https://doi.org/10.1007/s11524-007-9162-x

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